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OT Hospice

Annette Posted Wed 07th of August, 2019 10:03:57 AM
We provided OT at home for a patient on Hospice. We were told to bill Medicare Part B even though they are on Hospice. Medicare rejected it saying the patient is on Hospice. Do we code it differently than a normal Home Care Patient? We billed 97166 GO, 97530 GO and 97535 GO all with POS 12.
SuperCoder Answered Thu 08th of August, 2019 07:45:30 AM

Hi,

 

As per the CMS guidelines, the appropriate service code for OT in hospice setting is G0152 (Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes) and the POS should be 34.

For billing G0152, each visit is identified on a separate line item with the appropriate line item date of service and a charge amount. The units reported on the claim are the multiplier for the total time of the visit defined in the HCPCS description.

Note: As per the guidelines, G0152 should not be reported with CPT occupational therapy codes 97150, 97530 to 97535, 97542 to 97545, or 97750.

 

Please also check below link (Page 25):

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R3032CP.pdf

 

Hope this helps

 

Thanks

 

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